Provider Demographics
NPI:1538129671
Name:OLSON, BONNIE GAIL (RPH)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:GAIL
Last Name:OLSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 SE 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2936
Mailing Address - Country:US
Mailing Address - Phone:352-624-9223
Mailing Address - Fax:
Practice Address - Street 1:1 FLETCHER DR
Practice Address - Street 2:PHARMACY SHCC UNIVERSITY OF FLORIDA
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-7500
Practice Address - Country:US
Practice Address - Phone:352-392-1760
Practice Address - Fax:352-846-1521
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 15815183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS15815OtherPHARMACY LICENSE NO.